국소진행 두경부 상피세포암에서 선행유도약물요법 후 보조약물요법의 효과

김철우; 노재경; 안중배; 박준오; 정소영; 이석; 이혜란; 이경희; 정현철; 김주항; 김병수; 서창옥; 김귀언

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자료유형: 학술저널

저자정보: 김철우 (연세대학교 의과대학 내과학교실) 노재경 (연세대학교 의과대학 내과학교실) 안중배 (연세대학교 의과대학 내과학교실) 박준오 (연세대학교 의과대학 내과학교실) 정소영 (연세대학교 의과대학 내과학교실) 이석 (연세대학교 의과대학 내과학교실) 이혜란 (연세대학교 의과대학 내과학교실) 이경희 (연세대학교 의과대학 내과학교실) 정현철 (연세대학교 의과대학 내과학교실) 김주항 (연세대학교 의과대학 내과학교실) 김병수 (연세대학교 의과대학 연세 암센터) 서창옥 (연세대학교 의과대학 치료방사선과학교실) 김귀언 (연세대학교 의과대학 치료방사선과학교실)

저널정보: 대한두경부종양학회 대한 두경부 종양 학술지 대한 두경부 종양 학술지 제10권 제1호

발행연도: 1994.1

수록면: 13 - 24 (12page)

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Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

#Head and neck cancer #Inducation chemotherapy #Adjuvant chemotherapy

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주요연구분야 자연과학 > 생물학 의약학 > 임상의학 > 일반 외과학

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소속기관 연세대학교 의과대학 내과학교실